Structured physical exercise interventions and children and adolescents with attention deficit hyperactivity disorder: A systematic review and meta‐analysis

Abstract

BackgroundThe efficacy of structured physical exercise (SPE) has been examined in empirical studies to treat attention deficit hyperactivity disorder (ADHD). This review aimed (i) to systematically review and quantify the effects of SPE on ADHD symptomology and executive function (primary outcomes) and on physical health, physical fitness and mental health issues (secondary outcomes) in children/adolescents with ADHD; (ii) to evaluate the study quality and explore moderation of the effects of SPE; and (iii) to summarize the design of SPE interventions.MethodsAn extensive literature search in the databases of PubMed, Web of Science and EBSCOhost was conducted to identify eligible intervention studies for meta‐analysis. A descriptive account of the features of the studies is provided, including assessment of risk/quality (ROB‐2/ROBINS‐I). Standardized mean difference (SMD) with 95% confidence intervals (CIs) were calculated with random effects models to compare post‐intervention effects.ResultsA total of 18 studies were included in the review. The majority of the studies examined the effects of SPE lasting for 3–12 weeks. Assessment of bias/quality indicated half of the included studies as high quality. The meta‐analysis (pooled n = 627) revealed that SPE had a positive effect on primary and secondary outcomes, that is, inattention (SMD = −1.79), executive function (SMD = 2.19), physical fitness (SMD = 1.39) and mental health issues (SMD = −0.89). Subgroup analysis showed that long‐term practice of SPE, featured/tailored SPE, non‐Chinese participants, taking methylphenidate and study with low quality had larger effects.ConclusionsThere is emerging evidence that SPE is a promising option to enhance symptom management and physical/mental health in children/adolescents with ADHD.

Neurocognitive training enhances the outcomes of children with attention deficit hyperactivity disorder: A preliminary study

“…Moreover, it is specified that the teaching plan should include game content (Sun et al, 2022). Structured physical exercises have also been reported to be beneficial for symptoms in children and adolescents with ADHD (Sun et al, 2024). Neudecker et al (2019) emphasized that it is important to use perceptual-motor exercises such as planned and combined exercises and motor planning skills in ADHD.…”

“…When deciding on a treatment method, it is generally thought pharmacological practices cause addiction in children and that these practices predispose the child to controlled substance use in life; hence, non-stimulant or non-pharmacological methods may be preferred by the child's parents (Ng et al, 2017). Aerobic exercises, structured physical exercise and various other forms of physical activities have been identified as effective strategies for alleviating ADHD symptoms and enhancing neuropsychological parameters (Kamp et al, 2014;Sun et al, 2022Sun et al, , 2024Zhu et al, 2023). Furthermore, engaging in physical exercise has been shown to augment the response to pharmacotherapy (Klil-Drori & Hechtman, 2016).…”

“…In recent years, studies have stated using perceptual-motor exercises that include cognitive tasks and structured physical exercise programmes in children with ADHD (Sun et al, 2022;Sun et al, 2024). Sun et al (2022) indicated that aerobic exercise or perceptual-motor training combined with cognitive tasks is beneficial for children with ADHD.…”

“…Many different types of exercise interventions were employed for children with ADHD, and it is emphasized that a structured and specialized protocol can lead to better results in the management of ADHD (Kamp et al, 2014;Klil-Drori & Hechtman, 2016;Sun et al, 2022;Sun et al, 2024). However, many studies have usually examined the effects of non-specific exercise programmes or shortterm effects of the exercise.…”